US11224355B2 - MR imaging with optimized imaging workflow - Google Patents
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Definitions
- the present embodiments relate to a magnetic resonance (MR) imaging method with an imaging workflow, a breathing monitoring device, and a magnetic resonance imaging system.
- MR magnetic resonance
- MR imaging is performed during a time interval in which the patient is holding his/her breath.
- the MR imaging process is divided into a plurality of time sections or time intervals, in which MR signals of an area of the patient to be examined are recorded.
- a series of image acquisitions that are distributed over the cited recording time intervals is therefore carried out. These recording time intervals are thus synchronized with the breathing movement of the patient in that the recordings coincide with the resting breathing state of the patient.
- the patient is to regularly hold his/her breath.
- acoustic instructions are issued automatically to the patient to hold his/her breath during the course of the breathing-out process or breathing-in process.
- the actual MR imaging process e.g., scan process
- a partial sequence thereof is carried out.
- patients do not always follow the given instructions as desired. Instead, the patient may require additional time until the patient is completely at rest. Therefore, the first image acquisitions of a series of image recordings are in most cases compromised by the movement of the patient.
- a contrast agent may also be used with such a temporally clocked workflow.
- a distinction is made between the different phases of the accumulation of the contrast agent.
- a first phase there is still no contrast agent in an area to be examined.
- An MR image recording is also carried out in this first phase in order subsequently to have available a comparison between a contrast agent-supported image recording and an image recording without contrast agent.
- the contrast agent flows through the veins of the patient.
- the contrast agent is located in an area to be examined.
- a fourth phase e.g., post contrast phase
- Image recordings are conventionally executed in all four phases.
- a test bolus may be provided in advance, for example, with which the temporal course of the accumulation of the contrast agent is determined in advance.
- a clocked workflow therefore additionally includes the synchronization of the image recordings with the individual phases of the contrast imaging.
- the breath-holding commands are temporally attuned to the individual phases of the contrast agent accumulation.
- magnetic resonance imaging methods are used with iterative reconstruction techniques, such as “compressed sensing,” for example. Higher time resolutions may be achieved as a result.
- iGRASP iterative goldenangle radial sparse parallel MR imaging—iterative magnetic resonance imaging method with parallel subscanning with a radial k-space trajectory, the adjacent radial trajectory segments of which in the golden angle are oriented in relation to one another), which is to represent the course of a contrast agent when the patient is breathing freely.
- This technology allows a diagnostically relevant image quality to be achieved in patients who are not able to hold their breath for long enough.
- the iGRASP technology is shown, for example, in Magnetic Resonance in Medicine; Volume 72, Issue 3, pages 707-717, September 2014.
- the image quality is, however, frequently reduced in comparison with a standard measurement with breathing commands (e.g., clocked workflow) and cooperative patients. Therefore, in order to achieve an optimal image quality prior to the measurement, an assessment is carried out to determine whether the patient is able to hold air for long enough and whether the clocked workflow may be used. If the patient is not able to do this, the described iGRASP imaging method is employed. Otherwise, the clocked workflow is used. With an incorrect assessment, the quality of the recorded images is possibly not adequate for a diagnosis, or the result of the MR image recording is not optimal.
- MR magnetic resonance
- an MR imaging method that may be used when breathing freely is integrated in a workflow in which a breath-holding command is output.
- a breath-holding command is output to the patient (e.g., automatically).
- an MR imaging with a motion-insensitive MR imaging method that may be used when breathing freely is started.
- Such a motion-insensitive MR imaging method that may be used when breathing freely is to be as insensitive to movement as possible. This may be achieved, for example, by an adjusted reconstruction (e.g., compressed sensing), a specific measuring method (e.g., radial scanning), and/or high speed.
- the patient is thus monitored to determine whether the patient has correctly realized the instruction.
- the monitoring is carried out by an evaluation of data determined with the MR imaging method that may be used when breathing freely.
- a breathing movement of the patient is detected based on measurement data acquired when the MR imaging method is performed.
- the acquired measurement data may be used to determine a time relationship between the breathing movement of the patient and the breath-holding command. This time relationship may then be used for this purpose to modify the imaging workflow as a function of the determined time relationship.
- the modification of the workflow may include, for example, adjusting the time instant of outputting the breathing commands to the behavior of the patient.
- a minimum quality is provided in the imaging by using an MR imaging method that supplies an adequate imaging quality even when breathing freely.
- the MR imaging method of one or more of the present embodiments is superior to a method that functions entirely without a breath-holding command, since in terms of cooperation of the patient, the MR imaging method has a better image quality than the former.
- the method of one or more of the present embodiments is superior to an imaging method that operates with breath-holding commands but is prone to a non-compliance of these commands.
- An improved imaging quality is achieved by the use of an imaging method that is more robust with respect to a breathing movement and by a monitoring of the breathing movement or of the breath-holding of the patient based on the imaging.
- an imaging method that is more robust with respect to a breathing movement and by a monitoring of the breathing movement or of the breath-holding of the patient based on the imaging.
- the breathing monitoring device of one or more of the present embodiments has a command output unit.
- the command output unit is configured to output a command to the patient to hold his/her breath.
- the breathing monitoring device of one or more of the present embodiments includes a start command output unit for starting an MR imaging with an MR imaging method that may be used when breathing freely.
- the breathing monitoring device of one or more of the present embodiments also has a breathing movement detection unit for detecting a breathing movement of the patient based on measurement data acquired when the MR imaging method was performed.
- the breathing monitoring device of one or more of the present embodiments has a time relationship determination unit for determining a time relationship between the breathing movement of the patient and the breath-holding command.
- the breathing monitoring device also includes a modification unit for modifying the imaging workflow as a function of the determined time relationship.
- the magnetic resonance imaging system of one or more of the present embodiments has a radio-frequency transmit system, a gradient system, and a control device (e.g., a controller).
- the control device is embodied to actuate the radio-frequency transmit system and the gradient system for a desired measurement based on a predetermined pulse sequence.
- the magnetic resonance imaging system of one or more of the present embodiments includes a breathing monitoring device of the present embodiments.
- Some of the components of the breathing monitoring device may be embodied mainly in the form of software components. This relates, for example, to the command output unit, the breathing movement detection unit, the time relationship determination unit, and the modification unit. These components, however, may also be realized in part (e.g., if particularly fast calculations are to be performed) in the form of software-supported hardware components (e.g., FPGAs or the like). Similarly, if, for example, what is concerned is merely a transfer of data from other software components, the interfaces may also be configured as software interfaces. In one embodiment, however, the interfaces may also be configured as interfaces constructed with hardware that are controlled by suitable software.
- a realization largely through software has the advantage that conventionally used control devices of magnetic resonance imaging systems may also be upgraded easily with a software update in order to operate in the manner according to one or more of the present embodiments.
- a suitable computer program product with a computer program that may be loaded directly into a memory storage device (e.g., a non-transitory computer-readable storage medium) of a magnetic resonance imaging system and/or into a memory storage device (e.g., a non-transitory computer-readable storage medium) of a control device of a magnetic resonance imaging system and has program portions (e.g. instructions) in order to carry out all the acts of the method when the computer program is executed in the control device is provided.
- Such a computer program product may include, in addition to the computer program, additional components such as, for example, documentation and/or additional components, and hardware components such as, for example, a hardware key (e.g., dongles) for use of the software.
- additional components such as, for example, documentation and/or additional components
- hardware components such as, for example, a hardware key (e.g., dongles) for use of the software.
- a computer-readable medium e.g., a non-transitory computer-readable storage medium such as a memory stick, a hard disk or another transportable or firmly installed data carrier on which the program portions of the computer program that may be read in and executed by a computer unit of the control device or of the magnetic resonance imaging system are stored
- a computer unit may serve for transport to the memory storage device of the control device and/or for storage in the magnetic resonance imaging system.
- the computer unit may, for example, have one or more cooperating microprocessors or the like.
- the MR imaging method upon determination of the time relationship, it is determined whether the patient has actually realized the breath-holding command. Within the scope of the modification act, a decision will be made as to whether the breath-holding command is to be completely omitted. This may be useful, for example, if the patient reacts to breathing commands in a completely unpredictable manner or too slowly. If the output of the breath-holding command is completely omitted, the MR imaging is carried out in accordance with one or more of the present embodiments with a robust MR imaging method in relation to a breathing movement or a robust MR pulse sequence in relation to a breathing movement, so that a good image quality is achieved during the examination despite the inadequate cooperation of the patient.
- the determination of the time relationship may include the determination with which time delay the breath-holding command was executed by the patient.
- a time difference between the time instant of outputting the breath-holding command and the occurrence of the resting breathing state is determined, for example.
- a decision is made to determine whether and how the time instant of the breath-holding command is to be changed and/or whether and how the start time of the MR imaging is to be modified. Therefore, a temporal adjustment both of the time instant of outputting the breathing command and also the time instant of the start of the imaging or an imaging sequence, which are selected such that the time interval of the resting breathing state and the time interval of an imaging coincide, may be carried out. This now permits the acquisition of MR signals to be carried out during the resting state of the patient, so that the image quality of the MR image recording is improved.
- a test run may be performed for the determination of the time difference between the time instant of outputting the breath-holding command and the occurrence of the resting breathing state, and the subsequent MR imaging or the associated imaging workflow is performed by taking the determined time difference into account.
- the workflow is therefore carried out already at the start of the image recording with adjusted time parameters, so that the image quality of the first acquisitions is also expected to be very good.
- the breathing movement of the patient is also monitored during the MR image recording, so that the respective start time instant of the recording time intervals may be adjusted to a possible change in behavior of the patient.
- the imaging method is contrast agent-supported.
- a contrast agent is injected into the patient in advance (e.g., before the examination).
- the contrast agent moves with the circulation of the patient to an area to be examined.
- the contrast agent may be used for an MR image recording with improved image contrast.
- a test bolus may be used in advance. Such a test bolus only has a minimal quantity of the contrast agent that is used subsequently for the MR imaging.
- the time instant of arrival of the test bolus in the area to be examined is determined. In this way, the temporal behavior or duration that an injected contrast agent requires in order to reach an area to be examined, is known.
- the MR imaging workflow is then performed by additionally taking into account the determined time instant of the arrival of the test bolus.
- the test bolus may be acquired in a test run before the actual imaging process. In this way, the arrival of the contrast agent bolus may be attuned to the imaging workflow, so that an improved image contrast is achieved.
- the time instant of outputting the instruction to hold his/her breath is selected such that the expected time instant of the patient holding his/her breath coincides with the time instant of the arrival of a contrast agent bolus in the area to be examined (e.g., in the area in which a contrast agent-supported imaging is performed).
- the imaging is carried out under optimal contrast conditions and, at the same time, during the resting breathing state of the patient, so that an optimal image quality may be achieved with an optimal contrast.
- an imaging method with iterative reconstruction technology is used as an MR imaging method.
- high quality images may be generated, thereby achieving a high time resolution, for example, with the aid of an iterative reconstruction.
- An imaging method with radial scanning may be used as an MR imaging method.
- a radial MR imaging method is advantageous in that the radial MR imaging method is robust with regards to movements.
- the imaging method may be an iGRASP imaging method, for example.
- the measurement data determined with the MR imaging method in the detection act of a breathing movement of the patient may include raw data, for example.
- the raw data may have data from magnetic resonance signals from the k-space center of a trajectory used in the imaging for scanning the k-space.
- No image data has to be reconstructed for a detection of the breathing movement of the patient (e.g., the acquired raw data need not be transformed into the image data space).
- a reconstruction with the aid of a transformation of the raw data into the image data space is computationally complicated and uses considerable computing capacity and time. Since the reconstruction of image data may be dispensed with in the MR imaging method for the detection of the breathing behavior of the patient, the detection of the breathing movement may be performed rapidly (e.g., in real-time).
- the MR imaging method may have a clocked workflow as an imaging workflow.
- a clocked workflow is well suited to an interactive imaging, in which information about the movement of the patient is collected and the breathing movement of the patient is influenced such that the breathing movement of the patient remains in the resting breathing state during the time interval of an MR imaging.
- FIG. 1 shows a flow diagram that illustrates a contrast-enhanced MR imaging method according to an exemplary embodiment
- FIG. 2 shows a flow diagram that illustrates a contrast-enhanced MR imaging method according to a second exemplary embodiment
- FIG. 3 shows a block diagram that illustrates a breathing monitoring device according to an exemplary embodiment
- FIG. 4 shows a magnetic resonance imaging system according to an exemplary embodiment.
- FIG. 1 shows a flow diagram 100 that illustrates a contrast-enhanced magnetic resonance (MR) imaging method according to an exemplary embodiment.
- an acoustic command AAH(t AAH ) to the patient to hold his/her breathing movement is issued firstly automatically at a time instant t AAH . In this exemplary embodiment, this occurs within the scope of a clocked workflow.
- a contrast-enhanced MR imaging BG(t MR ) that also delivers an acceptable image quality with free breathing is then started at a time instant t MR .
- a contrast agent was provided in advance for the contrast-enhanced imaging.
- An iGRASP method may be used as an imaging method, for example.
- act 1.III it is determined whether the breath-holding command AAH is actually realized. This may take place based on measurement data acquired with the aid of the iGRASP method. For example, the raw data of the k-space center acquired with the MR image recording is used as a breathing signal (e.g., as proof as to whether or not a breathing movement has taken place). In the case that there has been absolutely no holding of breath, which is indicated in FIG. 1 with “n”, a move is made to act 1.IV. In act 1.IV, the MR imaging is then continued entirely without the breath-holding command AAH and finally terminated. Since an iGRASP method that is particularly robust with regard to a breathing movement of a patient is used for the MR imaging, despite omitting the breath-holding commands conventional for the clocked workflow, an acceptable image quality is achieved.
- FIG. 2 illustrates a contrast-enhanced MR imaging method according to a second exemplary embodiment.
- a type of upstream test run is used to determine both the reaction time t u of the patient and also the bolus time t B during which a contrast agent bolus arrives at an area to be examined.
- the time instant of starting the imaging t MR and the time instant t AAH of outputting the breath-holding command may thus be attuned to the determined times t u , t B .
- a test bolus is given to the patient. In other words, a small quantity of contrast agent is injected into the patient in advance.
- a breath-holding command AAH is given to the patient.
- an MR test imaging MR-TBG is started in act 2.II at a test start time instant t MR .
- a reaction time t u of the patient to the breath-holding command AAH is determined in act 2.III based on the recorded test images.
- a time t B is determined in act 2.IV based on the measurement data recorded in the test imaging MR-TBG, at which the test bolus has arrived at an area to be examined.
- act 2.V the actual contrast-enhanced imaging MR-BG takes place with a breath-holding command, which is attuned to the determined times t B , t u .
- the time instant of starting the imaging t MR and the time instant t AAH of outputting the breath-holding command are thus attuned to the determined times t u , t B .
- the arrival of the contrast agent bolus in the area to be examined and the image recording and the resting breathing state of the patient are synchronized so that a good image quality is to be expected with an increased contrast.
- a breathing monitoring device 30 is shown schematically in FIG. 3 .
- the breathing monitoring device 30 may be, for example, part of a control device of a magnetic resonance imaging system (see FIG. 4 ).
- the breathing monitoring device 30 includes a data acquisition unit 31 that receives raw data RD or also image data BD of an area to be examined, for example, acquired or reconstructed within the scope of an MR imaging method.
- the data RD, BD is transferred to a breathing movement detection unit 32 .
- the breathing movement detection unit 32 evaluates the acquired data RD, BD in order to determine whether and at which time instant a breath-holding command was performed by a patient. For example, a k-space center signal (e.g., raw data) acquired from the k-space center with the aid of the magnetic resonance imaging method may be evaluated herefor.
- the breathing movement detection unit 32 includes a time relationship determination unit 33 for determining a time relationship between the breathing movement of the patient and the breath-holding command AAH. For this purpose, the time relationship determination unit 33 determines a time instant at the start of a resting breathing state based on the acquired raw data RD or image data BD. The time relationship determination unit 33 determines a time difference to between the time instant t AAH of outputting the breath-holding command AAH and the reaction of the patient.
- the breathing movement detection unit 32 includes a modification unit 34 for modifying the imaging workflow as a function of the determined time relationship. In other words, the modification unit 34 determines correction parameters based on the time difference t u . Correction parameters may have, for example, a modified start time t MR of an MR imaging or a modified time instant t AAH of outputting a breath-holding command AAH.
- the breathing movement detection unit 32 After evaluating the acquired data RD, BD, the breathing movement detection unit 32 outputs information relating to a modified time instant t AAH of outputting a breath-holding command AAH to a command output unit 35 or alternatively also a command in order to set the output of breath-holding commands AAH entirely.
- the breathing movement detection unit 32 is also connected to a start command output unit 36 .
- the start command output unit 36 outputs a command SB to start an MR imaging with an MR imaging method that may be used with free breathing.
- the time instant t MR for outputting the start command SB is, as already explained, likewise determined by the breathing movement detection unit 32 and transferred to the start command output unit 36 .
- the time instant t MR for outputting the start command SB and thus the start time instant t MR of the imaging may be associated with the time instant t B of the arrival of a contrast agent bolus.
- the time instant t B of the arrival of the contrast agent may be determined by an MR test imaging MR-TBG performed in advance (e.g., prior to the actual contrast agent imaging).
- the breathing monitoring device 30 also includes an output interface 37 for outputting received image data BD or received raw data RD, which includes breathing movement data that is forwarded to a display unit (not shown), for example, for graphical representation or to another processing unit for further processing.
- the magnetic resonance system 1 includes the actual magnetic resonance scanner 2 with an examination space 3 or patient tunnel, into which an examination object O or a patient or test subject may be introduced on a couch 8 .
- the examination object or the examination area e.g., a specific organ
- the examination object or the examination area may be located in the patient or the test subject.
- the magnetic resonance scanner 2 is equipped in the usual manner with a main field magnet system 4 , a gradient system 6 , and an RF transmitting antenna system 5 and an RF receiving antenna system 7 .
- the RF transmitting antenna system 5 is a whole body coil fixedly incorporated in the magnetic resonance scanner 2
- the RF receiving antenna system 7 consists of local coils to be arranged on the patient or test subject (in FIG. 4 symbolized only by a single local coil).
- the whole-body coil may be used as an RF receiving antenna system, and the local coils may be used as an RF transmitting antenna system. These coils may each be switched to different operating modes.
- the MR system 1 also has a central control device 13 that is used for controlling the MR system 1 .
- This central control device 13 includes a sequence control unit 14 for pulse sequence control.
- the sequence of radio-frequency pulses (RF pulses) and gradient pulses may be controlled depending on a selected imaging sequence.
- RF pulses radio-frequency pulses
- Such an imaging sequence may be predefined, for example, within a measurement or control protocol.
- different control protocols are stored in a memory 19 for different measurements and may be selected by an operator (and where appropriate, altered if need be) and then used to perform the measurement.
- the central control device 13 For the output of the individual RF pulses, the central control device 13 has a radio-frequency transmitting device 15 that generates the RF pulses, amplifies the RF pulses, and feeds the RF pulses by a suitable interface (not shown in detail) to the RF transmitting antenna system 5 .
- the control device 13 In order to control the gradient coils of the gradient system 6 , the control device 13 has a gradient system interface 16 .
- the sequence control unit 14 communicates in a suitable manner, for example, by transmission of sequence control data SD, with the radio-frequency transmitting device 15 and the gradient system interface 16 for transmission of the pulse sequence.
- the control device 13 also has a radio-frequency receiving device 17 (also communicating in a suitable manner with the sequence control unit 14 ) in order to acquire magnetic resonance signals (e.g., raw data) in a coordinated manner from the RF transmitting antenna system 7 .
- a reconstruction unit 18 takes over the acquired raw data and reconstructs the MR image data therefrom. This image data may then be stored in a memory 19 , for example.
- the acquired raw data RD or the reconstructed image data BD is further processed in a breathing monitoring device 30 to control and monitor an MR imaging.
- the breathing monitoring device 30 provides a control command SB to the sequence control unit 14 , for example, to start an MR image recording sequence with the aid of the output of sequence control data SD.
- the breathing monitoring device 30 also includes a connection to an audio communication unit 11 on the magnetic resonance scanner 2 to transmit breath-holding instructions AAH to the patient O.
- the central control device 13 may be operated via a terminal with an input unit 10 and a display unit 9 , by which the whole MR system 1 may thus also be operated by an operating person.
- MR images may also be displayed on the display unit 9 , and using the input unit 10 , if appropriate in combination with the display unit 9 , measurements may be planned and initiated, and for example, suitable control protocols with suitable measurement sequences as explained above may be selected and, if appropriate, modified.
- the MR system 1 and the control device 13 may also include a plurality of other components that are not shown individually but are normally present in such systems (e.g., a network interface to link the whole system to a network, and to be able to exchange raw data and/or image data, as well as other data such as patient-related data or control protocols).
- a network interface to link the whole system to a network, and to be able to exchange raw data and/or image data, as well as other data such as patient-related data or control protocols.
- the method and the breathing monitoring device 30 were primarily explained in conjunction with a contrast agent-supported recording of medical image data.
- the invention is, however, not restricted to an MR image recording combined with a contrast agent provided in advance.
- the invention may instead also essentially be applied to the recording of images without additional administration of contrast agents.
- the use of the indefinite article “a” or “an” does not preclude the relevant feature from also being present plurally.
- the expression “unit” does not preclude this consisting of a plurality of components that may also be spatially distributed.
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Abstract
Description
t AAH =t MR −t u. (1)
t MR =t B. (2)
t AAH =t B −t u. (3)
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